Reconstructing Merck's Practical Theory of Communication: The Ethics of Pharmaceutical Sales Representative-Physician Encounters
This essay considers the ways in which Merck, a major pharmaceutical company, trained salespeople to communicate with physicians about its controversial pain drug, Vioxx. Between 2000 and 2004, approximately 60,000 people died while taking the drug. In this study, we analyzed 989 pages of internal training materials that show how Merck taught employees to communicate with physicians. Inspired by Craig and Tracy, we reconstruct the (1) guiding philosophies, (2) assumed problems, and (3) skills and techniques inherent in Merck's practical theory of communication. Using Nilsen's perspective on ethics, we argue that Merck taught a communication approach that obscured physicians' ability to make a significant choice and unnecessarily put more patients' lives at risk. The essay underscores the need to make communication ethics a primary rather than a secondary research concern.